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Michael Holmes , LAT, ATC

Specialist/Technologist - Athletic Trainer β€’ Fort Wayne, IN

Active NPI 1386095412 Individual Practitioner Male Practitioner
Practice location in NPPES

3946 Ice Way
Fort Wayne, IN 468051018

Call 2602664005 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

3946 Ice Way

Fort Wayne, IN 468051018

Telephone 2602664005

NPI first issued

2016

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Fort Wayne and Indiana

188 active clinicians are listed under Specialist/Technologist - Athletic Trainer with a practice address in Fort Wayne, IN (1,593 in Indiana).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Fort Wayne

0% of these 188 clinicians have the CMS telehealth indicator.

0% of these 188 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-02-24
Specialist/Technologist - Athletic Trainer Primary Specialty

NUCC Taxonomy Code: 2255A2300X

License # reported to NPPES IN 36003136A

Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.

Specialist/Technologist - Athletic Trainer

NUCC Taxonomy Code: 2255A2300X

License # reported to NPPES TX AT6680

Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.

Specialist/Technologist - Athletic Trainer

NUCC Taxonomy Code: 2255A2300X

License # reported to NPPES CO AT.0001813

Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Indiana Professional Licensing Agency.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

6 listed
Jodi Chambers , PA

Physician Assistant

NPI 1487646469

Physician Assistant

NPI 1811444763

Physician Assistant (Certified), Licensed Athletic Trainer, Certified Athletic Trainer

Anne Fisher , PA-C

Physician Assistant

NPI 1346421864

Physician Assistant (Certified)

Austin Shepard

Physician Assistant

NPI 1194595090
Benjamin Steele , PA-C

Physician Assistant

NPI 1710395736

Physician Assistant (Certified)

Dr. Hannah Zak , PT, DPT

Physical Therapist

NPI 1265002620

Physical Therapist, Doctor of Physical Therapy

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

16 Historical Events
πŸ“
Updated Practice Location February 24, 2025

Registered at 3946 ICE WAY, FORT WAYNE, IN 468051018 (Tel: 2602664005)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 24, 2025

Specialist/Technologist (license number reported to NPPES: TX AT6680)

πŸ“
Updated Practice Location January 19, 2020

Registered at 800 W STADIUM AVE, WEST LAFAYETTE, IN 479072046 (Tel: 5178991879)

πŸ“
Updated Business Mailing Address January 19, 2020

Registered at 1542 WEBSTER ST, WABASH, IN 469923533 (Tel: 5178991879)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 19, 2020

Specialist/Technologist (license number reported to NPPES: IN 36003136A)

βœ…
NPI Profile Active January 29, 2017

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location January 29, 2017

Registered at 1500 S UNIVERSITY PARKS DR, WACO, TX 767061731 (Tel: 5178991879)

πŸ“
Updated Business Mailing Address January 29, 2017

Registered at 1500 S UNIVERSITY PARKS DR, WACO, TX 767061731

πŸ‘€
Provider Name / Credentials Updated January 29, 2017

Recorded as MICHAEL HOLMES, LAT, ATC

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 29, 2017

Specialist/Technologist (license number reported to NPPES: TX AT6680)

βœ…
NPI Profile Active August 07, 2016

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) August 07, 2016

Registered at 1500 S UNIVERSITY PARKS DR, WACO, TX 767061731 (Tel: 5178991879)

πŸ“
Business Mailing Address (Initial Record) August 07, 2016

Registered at 1500 S UNIVERSITY PARKS DR, WACO, TX 767061731

πŸ‘€
Provider Name / Credentials (Initial Record) August 07, 2016

Recorded as MICHAEL HOLMES, ATC, CKTP

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 07, 2016

Specialist/Technologist (license number reported to NPPES: TX AT6680)

🟒
Initial NPI Registration & Enumeration June 30, 2016

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1386095412
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 30, 2016
Last Update: February 24, 2025
Sole Proprietor: No

Mailing Address

1542 Webster St

Wabash, IN 469923533

Phone: 5178991879

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.